McEntee Rachel K, Hitt Juvena R, Sieja Amber
Department of Medicine, University of Vermont Larner College of Medicine, University of Vermont Health Network, Burlington, Vermont, United States.
Department of Medicine Quality Program, University of Vermont Larner College of Medicine, Vermont, United States.
Appl Clin Inform. 2025 Jan;16(1):128-136. doi: 10.1055/a-2437-0185. Epub 2024 Oct 9.
This study aimed to describe the current landscape of electronic health record (EHR) training and optimization programs (ETOPs) and their impact on health care workers' (HCWs) experience with the EHR.
A 72-question electronic survey was developed and distributed to health care organization (HCO) leaders in clinical informatics (Chief Medical Information Officer [CMIO]/Chief Nursing Information Officer [CNIO]/Medical Informatics Executive, Associate CMIO/Medical Director of, Clinical/Nurse/Physician Informaticist) through various channels such as national informatics conferences, social media, and email distribution lists of vendors and informatics associations. The survey collected data on the characteristics, resourcing, approach, and outcomes of ETOPs. Descriptive statistics were applied to analyze the data.
There were 193 responses from 147 distinct HCOs. Of these, 69% offer ongoing EHR training, and 52% offer some version of an ETOP. Offered ETOPs vary in their timing, modality, audience, team composition, duration, and EHR build strategy. The most commonly measured outcomes were EHR satisfaction, efficiency, and provider burnout, and most ETOPs reported improvement in these areas.
The findings suggest that ETOPs are inconsistently implemented across HCOs, and while there are some commonalities, there is a wide variety of designs and methods of evaluation for the programs. Though the problems to solve (EHR efficiency, proficiency, and satisfaction) are the same, the organizational structure and culture of HCOs vary widely, which may partially explain the variability seen in reported ETOPs. When considering the measured outcomes, ETOPs may have direct and indirect effects on HCW burnout by improving EHR efficiency and satisfaction, as well as driving organizational culture toward teamwork and flexible problem-solving. For this reason, ETOPs may also serve as a model for addressing other challenges in health care delivery. ETOPs are a promising intervention to enhance HCW experience with the EHR and reduce burnout. More research is needed to identify the optimal features, methods, and outcomes of ETOPs, and to disseminate them across HCOs.
本研究旨在描述电子健康记录（EHR）培训与优化项目（ETOP）的当前状况及其对医护人员使用EHR体验的影响。
设计了一份包含72个问题的电子调查问卷，并通过各种渠道分发给医疗保健组织（HCO）的临床信息学负责人（首席医疗信息官[CMIO]/首席护理信息官[CNIO]/医学信息主管、CMIO助理/临床/护士/医师信息学家医学主任），如全国信息学会议、社交媒体以及供应商和信息学协会的电子邮件分发列表。该调查收集了有关ETOP的特征、资源配置、方法和结果的数据。应用描述性统计分析数据。
来自147个不同HCO的193份回复。其中，69%提供持续的EHR培训，52%提供某种形式的ETOP。所提供的ETOP在时间安排、模式、受众、团队构成、持续时间和EHR构建策略方面各不相同。最常衡量的结果是EHR满意度、效率和医护人员职业倦怠，大多数ETOP报告在这些方面有所改善。
研究结果表明，ETOP在HCO之间的实施不一致，虽然存在一些共性，但项目的设计和评估方法多种多样。尽管要解决的问题（EHR效率、熟练程度和满意度）相同，但HCO的组织结构和文化差异很大，这可能部分解释了所报告的ETOP的变异性。考虑到所衡量的结果，ETOP可能通过提高EHR效率和满意度以及推动组织文化向团队合作和灵活解决问题的方向发展，对医护人员职业倦怠产生直接和间接影响。因此，ETOP也可作为应对医疗服务中其他挑战的模式。ETOP是一种有前景的干预措施，可增强医护人员使用EHR的体验并减少职业倦怠。需要更多研究来确定ETOP的最佳特征、方法和结果，并在HCO之间进行推广。
